Here’s What You Can Do in a Crisis

Psychological First Aid is something we can all learn.

Victims of the massacre in Parkland, Fl. SOURCE.

We are all going to be involved in a crisis at some point. The sheer volume of violence and mayhem in this country makes it a mathematical certainty. Every year, suicides alone account for fatalities 15 times greater than those we suffered on 9/11. Forget foreign terrorism; Americans are the most dangerous thing happening to other Americans. Nothing else comes close.

And, as the federal government is loath to do anything at all about mass shootings in this country — or the 9,000 or so killed every year from gang violence in our inner cities, or the 35,000 we lose each year to the opioid epidemic, or the 45,000 we lose every year to suicide, or the 100,000 we lose to alcohol-related accidents — it’s time to equip ourselves with basic crisis response skills. There are too many awful things happening to expect first responders to handle things on their own, so we have no choice but to get creative.

At the very least though we can learn how to help each other. It’s called “Psychological First Aid,” and you can learn the basics in about six hours. It is an ingenious, effective, and simple set of interventions to use in a crisis. And remember, you are definitely going to be involved in a crisis. Because, America.

Psychological First Aid (PFA) is an evidence-informed approach that is built on the concept of human resilience. PFA aims to reduce stress symptoms and assist in a healthy recovery following a traumatic event, natural disaster, public health emergency, or even a personal crisis. — Minnesota Dept. of Public Health (link)

In 2006, The National Center for Post Traumatic Stress Disorder (NCPTSD), a division of the US Department of Veterans Affairs, developed Psychological First Aid (PFA) to assist children, adults, and families in the aftermath of both natural and man-made disasters, including mass-shootings and terrorism.

Police, firemen, paramedics, and other first responders are trained in it, and it was developed for non-mental health professionals to use, so there’s no reason the average person can’t use it, too. And remember — mass murders, drug overdoses, gang wars, suicides, and acts of domestic violence are going to continue to occur unabated, so we might as well be prepared.

Psychological First Aid was designed for major disasters, but it’s useful in any situation where you’d find yourself helping a person in crisis. Keep in mind, a crisis is not so much an event, but a person’s reaction to it. Thus, the definition of “crisis” is subjective.

A crisis is also not confined to any one set of parameters. Obvious ones include school shootings — or Church shootings, or concert shootings, or baseball field shootings, because, America — natural disasters like hurricanes and tornadoes, and acts of domestic and foreign terrorism. But “lesser” disasters happen every few seconds (e.g., car crashes, untimely deaths, violent crime, and suicide). Then you have personal crises, such as job loss, extended illness, or a bad breakup. Psychological first aid can be used with all of these.

While there are core components and steps to Psychological First Aid, mostly it has to do with being a decent human being to other human beings who need help. If you can listen and demonstrate empathy, you can perform Psychological First Aid.

While Physical First Aid is used to reduce physical discomfort due to a bodily injury, Psychological First Aid is a strategy to reduce the painful range of emotions and responses experienced by people exposed to high stress — Minnesota Dept. of Public Health (link)

It might sound like overkill to advocate equipping every adult in the country with basic crisis skills, but we seem to have run out of options. This country has no respect at all for the needs of our mentally ill, nothing but contempt for people who suffer from the disease of addiction, and after 27 teachers and first graders were gunned down at Sandy Hook in 2012, we’re all apparently okay with mass child murder, so long as our gun rights aren’t infringed. No one is coming to rescue us.

What Psychological First Aid is (and is not).

PFA is designed with simplicity and ease of use in mind. With that in mind, let’s discuss first what it isn’t.

It isn’t counseling. It isn’t a clinical assessment. It doesn’t require you to obtain details of the traumatic event, nor does it involve diagnosis or labels or complex interventions. It’s not something only professionals can use, and not everyone involved in a trauma will actually need it. And it doesn’t require extensive training, special skills, or advanced degrees. In short, it is based on skills most people already possess.

The Minnesota Department of Public Health offers a wonderful summary of it on their website. There’s even an app you can download for both Android and iPhone.

Psychological First Aid is designed to help anyone — kids, adults, parents, senior citizens, even entire communities that have suffered a traumatic incident, as well as first responders and volunteers. It is also, by extension, remarkably effective for friends and family members dealing with every-day crises.crises.

When we are exposed to a trauma, be it a bad breakup or a car bomb, a number of common stress reactions can occur. Grief. Terror. Shock. Panic. Disbelief. Confusion. Physical pain. Insomnia. Anxiety. Social isolation. Guilt. Which ones we experience depend on who we are and what we have just experienced. There’s no right or wrong feeling, nor can you predict which ones a person will experience.

The goal of Psychological First Aid is to tend to these emotional wounds by providing safety, comfort, understanding, and hope. The World Health Organization produced an extensive handbook on how to do this, and other guides are readily available on the Internet, like this one, produced by the National Child Traumatic Stress Network. There are even a few tutorials online, like this one, from the University of Minnesota. Last but not least, there’s a free 6-hour online training course that’s actually endorsed by the American Psychological Association. You can access it here.

This country is either unwilling or unable to address any of the myriad life or death issues that confront us daily, so we might as well learn how to support one another. If there is another solution, it does not seem to be presenting itself. Common sense would suggest we would need to make things like mental illness, drug addiction, suicide, homicide, and domestic violence a priority, but we seem to only care about perceived threats beyond our borders, as if any country’s greatest threat isn’t rotting away its own soul from the inside.

Even if all that weren’t true, Psychological First Aid has its merits when it comes to helping our friends and loved ones through the more mundane and routine crises that define us all. It is easy to use, the training is free and readily available, and the practical applications are legion. Perhaps the key to large, systemic change begins with how we help our fellow man. If more of us were willing to do this, maybe the larger problems we face as a country would begin to take care of themselves.